Many of us are aware of the risk of ‘Heart disease’, know its risk factors like smoking, cholesterol, LDL, stress etc. and take them seriously. But the risk for ‘Cancer’? Not so serious? Wait!

You may be surprised from the US Government data for 2009. According to Center for Disease Control (1), Cancer is the second highest cause of death in the USA, very closely following heart disease. In 2009 heart disease caused 599413 deaths as #1 and Cancer was a close 567628 as #2. Cancer deaths are 95% of heart disease deaths, in spite of all the advances in screening and treatment! How less likely is death from cancer compared with death from heart disease? Hardly any difference.

If cancer is almost as likely to cause death as heart disease, do we know its risk factors? Can we do anything about the risk factors, rather than wait for it to be detected too late, as a death sentence?

I found from my personal experience that these are the popular beliefs and practices

Most cancers are genetically influenced and can’t be prevented. Exceptions are caused by smoking, exposure to asbestos and some chemicals.

Screening can’t detect all cancers. In some cases, by the time it is detected, it may be too late and it may not be possible to save life, only prolong it by a few years.

When it strikes, the treatment options are surgery, radiation and chemotherapy. After successful treatment, its recurrence is very likely and is a life long threat.

During and after treatment, hardly any self care prescriptions are given about what a patient can do, to reduce the risk factors and try to prevent its recurrence.

In this context, the book “The Cancer Survivor’s Guide – Foods that help you fight back” (2) by Neal Barnard M.D (3) may deserve your attention. The author cautions that you should involve your doctor in making any dietary changes. Other experts focus on the role of Smoking cessation, Environmental toxins, Exercise, Stress management and Social support in preventing and fighting cancer. Some links are at (4).

I also recommend the guide on “Prostate cancer prevention – Nutrition and Exercise” published by the Prostate cancer foundation (5).

Diet related suggestions from many sources are following. Diet is one of the key factors. Other equally important factors from other sources are exercise, relaxation and social support.

Enhance Fiber and cut down Fat: Diets high in fiber and low in fat, reduce the amount of estrogens (female sex hormones) circulating in the bloodstream, reducing the likelihood that cancer cells will multiply or spread. Fiber prevents colon cancer. It strengthens the immune system.

Avoid Dairy Products: Typical dairy products (milk, cheese, yogurt, and so forth) are high in fat and cholesterol. Dairy products appear to play an important role in cancer risk. The Physicians’ Health Study and the Health Professionals Follow-Up Study found that men who frequently consume dairy products had a higher prostate cancer risk.

Avoid Meat: Many research studies have shown that cancer is more common in populations consuming diets rich in fatty foods, particularly meat, and much less common in countries with diets rich in grains, vegetables, and fruits. This is partly due to the high-fat and fiber-free characteristics of meat compared to plant foods. When meats are cooked, cancer-causing chemicals called heterocyclic amines form within the meat.

Increase Antioxidants: They are powerful cancer fighters mainly found in vegetables and fruits. They assist in halting free radical damage, which can otherwise lead to cancer development.

Immune system’s role in fighting cancer: Beta-carotene, vitamin C, and zinc can help the immune system recognize and destroy cancer cells. Foods rich in fat and cholesterol can interfere with immunity. Studies show that vegetarians have approximately double the natural killer cell activity (natural killer cells engulf and destroy cancer cells) compared to non-vegetarians.

Maintaining a Healthy Weight: Healthy weight control is essential for warding off a variety of chronic diseases, and studies have shown that slimmer people are less likely to develop cancer. In addition, trimming excess weight may also improve survival after cancer has been diagnosed.

This is an article forwarded by a friend. He is not sure of its author.

What killed Ranjan Das and Lessons for Corporate India

A month ago, many of us heard about the sad demise of Ranjan Das from Bandra, Mumbai. Ranjan, just 42 years of age, was the CEO of SAP-Indian Subcontinent, the youngest CEO of an MNC in India. He was very active in sports, was a fitness freak and a marathon runner. It was common to see him run on Bandra’s Carter Road. Just after Diwali, on 21st Oct, he returned home from his gym after a workout, collapsed with a massive heart attack and died. He is survived by his wife and two very young kids. It was certainly a wake-up call for corporate India. However, it was even more disastrous for runners amongst us. Since Ranjan was an avid marathoner (in Feb 09, he ran Chennai Marathon at the same time some of us were running Pondicherry Marathon 180 km away), the question came as to why an exceptionally active, athletic person succumb to heart attack at 42 years of age. Was it the stress? A couple of you called me asking about the reasons. While Ranjan had mentioned that he faced a lot of stress, that is a common element in most of our lives. We used to think that by being fit, one can conquer the bad effects of stress. So I doubted if the cause was stress. The real reason however is … everyone missed out a small line in the reports that Ranjan used to make do with 4-5 hours of sleep. This is an earlier interview of Ranjan on NDTV in the program ‘Boss’ Day Out’:

Here he himself admits that he would love to get more sleep and that he was not proud of his ability to manage without sleep, contrary to what others extolled.

The evidence last week:
I was working with a well-known cardiologist on the subject of ‘Heart Disease caused by Lack of Sleep’. While I cannot share the video nor the slides because of confidentiality reasons, I have distilled the key points below in the hope it will save some of our lives.

Some excerpts …..

Short sleep duration (<5 or 5-6 hours) increased risk for high BP by 350% to 500% compared to those who slept longer than 6 hours per night. Paper published in 2009.

As you know, high BP kills. .. Young people (25-49 years of age) are twice as likely to get high BP if they sleep less. Paper published in 2006. ..

Individuals who slept less than 5 hours a night had a 3-fold increased risk of heart attacks. Paper published in 1999. ..

Complete and partial lack of sleep increased the blood concentrations of High sensitivity C-Reactive Protein (hs-cRP), the strongest predictor of heart attacks. Even after getting adequate sleep later, the levels stayed high!! .. Just one night of sleep loss increases very toxic substances in body such as Interleukin-6 (IL-6), Tumour Necrosis Factor-Alpha (TNF-alpha) and C-reactive protein (cRP). They increase risks of many medical conditions, including cancer, arthritis and heart disease. Paper published in 2004. ..

Sleeping for <=5 hours per night leads to 39% increase in heart disease. Sleeping for <=6 hours per night leads to 18% increase in heart disease. Paper published in 2006.

Ideal sleep for lack of space, I cannot explain here the ideal sleep architecture. But in brief, sleep is composed of two stages: REM (Rapid Eye Movement) and non-REM. The former helps in mental consolidation while the latter helps in physical repair and rebuilding. During the night, you alternate between REM and non-REM stages 4-5 times. The earlier part of sleep is mostly non-REM. During that period, your pituitary gland releases growth hormones that repair your body. The latter part of sleep is more and more REM type. For you to be mentally alert during the day, the latter part of sleep is more important. No wonder when you wake up with an alarm clock after 5-6 hours of sleep, you are mentally irritable throughout the day (lack of REM sleep). And if you have slept for less than 5 hours, your body is in a complete physical mess (lack of non-REM sleep), you are tired throughout the day, moving like a zombie and your immunity is way down (I’ve been there, down that lane)

Finally, as long-distance runners, you need an hour of extra sleep to repair the running related damage. If you want to know if you are getting adequate sleep, take the Epworth Sleepiness Test below. Use this form from Stanford University.

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How likely are you to doze off or fall asleep in the following situations, in contrast to feeling just tired? This refers to your usual way of life in recent times. Even if you have not done some of these things recently, try to work out how they would have affected you. Use the following scale to choose the most appropriate number for each situation:

0 = no chance of dozing

1 = slight chance of dozing

2 = moderate chance of dozing

3 = high chance of dozing

SITUATION CHANCE OF DOZING

Sitting and reading____________

Watching TV ____________

Sitting inactive in a public place (e.g a theater or a meeting) ____________

As a passenger in a car for an hour without a break ____________

Lying down to rest in the afternoon when circumstances permit ____________

Sitting and talking to someone ____________

Sitting quietly after a lunch without alcohol ____________

In a car, while stopped for a few minutes in traffic ____________

Interpretation: Score of 0-9 is considered normal while 10 and above abnormal.

If you are not getting enough sleep (7 hours), you are playing with fire, even if you have low stress. I always took pride in my ability to work 50 hours at a stretch whenever the situation warranted. But I was so spooked after seeing the scientific evidence last week that since Saturday night, I ensure I do not even set the alarm clock under 7 hours. Now, that is a nice excuse to get some more sleep.

Unfortunately, Ranjan Das is not alone when it comes to missing sleep. Many of us are doing exactly the same, perhaps out of ignorance. Please share this article with as many of your colleagues as possible, especially those who might be short-changing their sleep. If we can save even one young life because of this email, I would be the happiest person on earth.

PS: Incidentally, just as human beings need 7 hours of sleep, you should know that cats need 15 hours of sleep and horses need 3 hours of it. So are you planning to be a cool cat or a dumb horse?

I wanted to thank you for bringing your ‘Focusing on Breathing’ program to our library. The excellent comments from those who attended show how valuable this technique is. Thank you for sharing your knowledge and your enthusiasm with our library patrons.

Sincerely,”
Lois Papp
Head of Adult Services
East Greenbush Community Library